18 F-FLT?PET/CT对食管鳞癌放化疗效果预测研究

背景与目的： ¹⁸ F-FLT是一种细胞增殖的示踪剂。探索 ¹⁸ F-FLT PET/CT对食管鳞癌根治性放（化）疗效果的预测价值。方法：对根治性放（化）疗的初治食管鳞癌患者，放疗前及放疗第4周行 ¹⁸ F-FLT PET/CT扫描，记录原发灶的SUV _max-T 、转移淋巴结的SUV _max-N 等参数。随访患者总生存期（overall survival，OS）及无进展生存期（progression-free survival，PFS），分析PET/CT参数与患者预后的关系。结果：共入组39例患者，25例完成2次PET/CT扫描。 ¹⁸ F-FLT的SUV _max-T 由基线6.63下降到1.22，淋巴结SUV _max-N 由3.69下降到1.84，但下比例与生存率无关。 ¹⁸ F-FLT PET/CT的基线SUV _max-N ＜5.00的患者，其OS明显高于SUV _max-N ≥5.00的患者（P=0.002）。结论：对根治性放（化）疗食管鳞癌，治疗前的基线 ¹⁸ F-FLT PET/CT的淋巴结SUV _max-N 是一个较好的预测预后参数。放疗4周时，病灶在 ¹⁸ F-FLT PET/CT扫描中的SUV值明显下降，但不能预测预后。

Prognostic and predictive value of 18 F-FLT PET/CT in patients with esophageal squamous carcinoma treated by radiochemotherapy

Background and purpose: ¹⁸ F-FLT is a proliferative radiotracer. This study aimed to evaluate the prognosticvalue of functional molecular image of ¹⁸ F-FLT PET/CT taken before and in the process of radiotherapy. Methods: Patients with newly diagnosed esophageal squamous cell carcinoma (ESCC) were enrolled in the study. All patients received radiotherapy/chemoradiotherapy. The planned dose was 61.2 Gy and 1.8 Gy per fraction respectively. The concurrent chemotherapy was platinum, paclitaxel or fluoropyrimidine based. Patients were examined by PET with ¹⁸ F-fluoro-30-deoxy-30-L-fluorothymidine (FLT) at baseline and 4 weeks after treatment initiation. The overall survival (OS) and progression-free survival (PFS) were followed up. The SUV maximum (SUV _max ) of primary tumor and positive nodes were recorded. PET/CT findings were analyzed for the correlation with clinical response of patients and survival. Results: Thirty-nine patients were enrolled in the study, among whom 25 patients completed two planned PET/CT. Patients with SUV max-N ≥5.00 had worse OS (P=0.002) and PFS (P=0.01) than those with SUV _max-N <5.00. The SUV _max of both primary tumor and lymph nodes significantly decreased in the interim scan compared to the baseline scan in FLT PET/CT, but the relationship between the change of SUV _max and prognosis seemed to be weak. Conclusion: Baseline SUV _max of lymph node on ¹⁸ F-FLT PET/CT had prognostic value in patients with esophageal cancer undergoing radiotherapy/radiochemotherapy. The decrease of SUV _max of tumor after 4 weeks’ radiotherapy couldn’t predict prognosis properly.